Abstract

Individual change in behaviour has the potential to decrease the burden of chronic disease due to smoking, dietand low physical activity.Smoking quit rates can be increased by simple advice from a physician or trained counsellor, overall and in peopleat high risk of smoking related disease, with low intensity advice as effective as high intensity advice.Advice from a nurse, telephone counselling, individualised self help materials and taking exercise may also bebeneficial.Training health professionals increases the frequency of offering antismoking interventions but may not increasetheir effectiveness.Nicotine replacement therapy, bupropion and nortriptyline may improve short term quit rates as part of smokingcessation strategies.Moclobemide, selective serotonin reuptake inhibitors, anxiolytics and acupuncture have not been shown to bebeneficial.Smoking cessation programmes increase quit rates in pregnant women, but nicotine patches may not be beneficialcompared with placebo.Physical activity in sedentary people may be increased by counselling, with input from exercise specialists possiblybeing more effective than physicians, in women over 80 years and in younger adults.Advice on eating a low cholesterol diet leads to a mean 0.2 to 0.3 mmol/L decrease in blood cholesterol concentrationin the long term, but no consistent effect of this on morbidity or mortality has been shown.Intensive interventions to reduce sodium intake lead to small decreases in blood pressure, but may not reducemorbidity or mortality.Advice to lose weight leads to greater weight loss than no advice, and cognitive behavioural therapy may bemore effective than dietary advice.